IMG Roadmap

Overview

This roadmap gives you a clear, step-by-step picture of how international medical graduates move from being outside the UK to working confidently in the NHS. There is no single “perfect” route, but the stages are usually predictable.

Think of this as a journey with milestones, not a checklist you must complete perfectly.

Stage 1: Clarify Your Goal

Before exams or applications, ask yourself:

  • Do I want a training post or a trust-grade job first?

  • Which specialty interests me long-term?

  • Do I need UK experience before applying for training?

Many IMGs benefit from starting in a non-training job to understand the system first.

Stage 2: English & Licensing Requirements

Most doctors will need:

  • English language evidence (IELTS or OET)

  • A recognised medical degree

  • GMC registration route (PLAB, UKMLA, MRCP, MRCS, or accepted postgraduate qualification)

This is the administrative foundation of your journey.

Stage 3: GMC Registration

GMC registration is what legally allows you to work as a doctor in the UK. The route you take depends on your background:

  • PLAB / UKMLA route

  • Accepted postgraduate qualifications (e.g., MRCP)

  • Sponsorship or CESR routes (less common early on)

Without GMC registration, you cannot take up a clinical post.

Stage 4: First NHS Job

For many IMGs, this is the hardest but most important step.

Common first roles include:

  • Trust grade SHO

  • Clinical fellow

  • FY2-level LAT post

Your first job is about learning the system, not building a perfect CV.

Stage 5: Settling Into NHS Practice

Once you start working, priorities shift to:

  • Understanding ward workflow

  • Safe escalation

  • Good documentation habits

  • Building confidence in clinical decisions

  • Collecting evidence for portfolio

This stage is where most growth happens.

Stage 6: Building Your Portfolio

If you plan to apply for training (IMT, CST, specialty training), you will need:

  • Teaching

  • Audit / QIP

  • Courses and certificates

  • Reflections

  • Supervisor feedback

This does not need to happen all at once — consistency matters more than speed.

Stage 7: Applying for Training (Optional Path)

Some doctors remain in trust-grade roles long-term. Others apply for formal UK training pathways.

Both are valid. The right path is the one that fits your life, not someone else’s timeline.

Reality Check

Progress is rarely linear. Delays, rejections, exam failures, and job gaps happen to many excellent doctors. What matters most is persistence, adaptation, and continuous improvement.

Reassurance

You are not “behind”. You are simply on a different timeline. With the right guidance and steady effort, working confidently in the NHS is absolutely achievable.